Study protocol: Audit and Best Practice for Chronic Disease Extension (ABCDE) Project

<p>Abstract</p> <p>Background</p> <p>A growing body of international literature points to the importance of a system approach to improve the quality of care in primary health care settings. Continuous Quality Improvement (CQI) concepts and techniques provide a theoretic...

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Main Authors: Thompson Sandra, Condon John, O'Donohue Lynette, Dowden Michelle, Clark Louise, Weeramanthri Tarun, Connors Christine, Si Damin, Bailie Ross, Clelland Nikki, Nagel Tricia, Gardner Karen, Brown Alex
Format: Article
Language:English
Published: BMC 2008-09-01
Series:BMC Health Services Research
Online Access:http://www.biomedcentral.com/1472-6963/8/184
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author Thompson Sandra
Condon John
O'Donohue Lynette
Dowden Michelle
Clark Louise
Weeramanthri Tarun
Connors Christine
Si Damin
Bailie Ross
Clelland Nikki
Nagel Tricia
Gardner Karen
Brown Alex
author_facet Thompson Sandra
Condon John
O'Donohue Lynette
Dowden Michelle
Clark Louise
Weeramanthri Tarun
Connors Christine
Si Damin
Bailie Ross
Clelland Nikki
Nagel Tricia
Gardner Karen
Brown Alex
author_sort Thompson Sandra
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>A growing body of international literature points to the importance of a system approach to improve the quality of care in primary health care settings. Continuous Quality Improvement (CQI) concepts and techniques provide a theoretically coherent and practical way for primary care organisations to identify, address, and overcome the barriers to improvements. The Audit and Best Practice for Chronic Disease (ABCD) study, a CQI-based quality improvement project conducted in Australia's Northern Territory, has demonstrated significant improvements in primary care service systems, in the quality of clinical service delivery and in patient outcomes related to chronic illness care. The aims of the extension phase of this study are to examine factors that influence uptake and sustainability of this type of CQI activity in a variety of Indigenous primary health care organisations in Australia, and to assess the impact of collaborative CQI approaches on prevention and management of chronic illness and health outcomes in Indigenous communities.</p> <p>Methods/design</p> <p>The study will be conducted in 40–50 Indigenous community health centres from 4 States/Territories (Northern Territory, Western Australia, New South Wales and Queensland) over a five year period. The project will adopt a participatory, quality improvement approach that features annual cycles of: 1) organisational system assessment and audits of clinical records; 2) feedback to and interpretation of results with participating health centre staff; 3) action planning and goal setting by health centre staff to achieve system changes; and 4) implementation of strategies for change. System assessment will be carried out using a System Assessment Tool and in-depth interviews of key informants. Clinical audit tools include two essential tools that focus on diabetes care audit and preventive service audit, and several optional tools focusing on audits of hypertension, heart disease, renal disease, primary mental health care and health promotion.</p> <p>The project will be carried out in a form of collaborative characterised by a sequence of annual learning cycles with action periods for CQI activities between each learning cycle.</p> <p>Key outcome measures include uptake and integration of CQI activities into routine service activity, state of system development, delivery of evidence-based services, intermediate patient outcomes (e.g. blood pressure and glucose control), and health outcomes (complications, hospitalisations and mortality).</p> <p>Conclusion</p> <p>The ABCD Extension project will contribute directly to the evidence base on effectiveness of collaborative CQI approaches on prevention and management of chronic disease in Australia's Indigenous communities, and to inform the operational and policy environments that are required to incorporate CQI activities into routine practice.</p>
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spelling doaj.art-ce42a0f8184a4349b2d7ce58b3ae31d32022-12-22T01:42:22ZengBMCBMC Health Services Research1472-69632008-09-018118410.1186/1472-6963-8-184Study protocol: Audit and Best Practice for Chronic Disease Extension (ABCDE) ProjectThompson SandraCondon JohnO'Donohue LynetteDowden MichelleClark LouiseWeeramanthri TarunConnors ChristineSi DaminBailie RossClelland NikkiNagel TriciaGardner KarenBrown Alex<p>Abstract</p> <p>Background</p> <p>A growing body of international literature points to the importance of a system approach to improve the quality of care in primary health care settings. Continuous Quality Improvement (CQI) concepts and techniques provide a theoretically coherent and practical way for primary care organisations to identify, address, and overcome the barriers to improvements. The Audit and Best Practice for Chronic Disease (ABCD) study, a CQI-based quality improvement project conducted in Australia's Northern Territory, has demonstrated significant improvements in primary care service systems, in the quality of clinical service delivery and in patient outcomes related to chronic illness care. The aims of the extension phase of this study are to examine factors that influence uptake and sustainability of this type of CQI activity in a variety of Indigenous primary health care organisations in Australia, and to assess the impact of collaborative CQI approaches on prevention and management of chronic illness and health outcomes in Indigenous communities.</p> <p>Methods/design</p> <p>The study will be conducted in 40–50 Indigenous community health centres from 4 States/Territories (Northern Territory, Western Australia, New South Wales and Queensland) over a five year period. The project will adopt a participatory, quality improvement approach that features annual cycles of: 1) organisational system assessment and audits of clinical records; 2) feedback to and interpretation of results with participating health centre staff; 3) action planning and goal setting by health centre staff to achieve system changes; and 4) implementation of strategies for change. System assessment will be carried out using a System Assessment Tool and in-depth interviews of key informants. Clinical audit tools include two essential tools that focus on diabetes care audit and preventive service audit, and several optional tools focusing on audits of hypertension, heart disease, renal disease, primary mental health care and health promotion.</p> <p>The project will be carried out in a form of collaborative characterised by a sequence of annual learning cycles with action periods for CQI activities between each learning cycle.</p> <p>Key outcome measures include uptake and integration of CQI activities into routine service activity, state of system development, delivery of evidence-based services, intermediate patient outcomes (e.g. blood pressure and glucose control), and health outcomes (complications, hospitalisations and mortality).</p> <p>Conclusion</p> <p>The ABCD Extension project will contribute directly to the evidence base on effectiveness of collaborative CQI approaches on prevention and management of chronic disease in Australia's Indigenous communities, and to inform the operational and policy environments that are required to incorporate CQI activities into routine practice.</p>http://www.biomedcentral.com/1472-6963/8/184
spellingShingle Thompson Sandra
Condon John
O'Donohue Lynette
Dowden Michelle
Clark Louise
Weeramanthri Tarun
Connors Christine
Si Damin
Bailie Ross
Clelland Nikki
Nagel Tricia
Gardner Karen
Brown Alex
Study protocol: Audit and Best Practice for Chronic Disease Extension (ABCDE) Project
BMC Health Services Research
title Study protocol: Audit and Best Practice for Chronic Disease Extension (ABCDE) Project
title_full Study protocol: Audit and Best Practice for Chronic Disease Extension (ABCDE) Project
title_fullStr Study protocol: Audit and Best Practice for Chronic Disease Extension (ABCDE) Project
title_full_unstemmed Study protocol: Audit and Best Practice for Chronic Disease Extension (ABCDE) Project
title_short Study protocol: Audit and Best Practice for Chronic Disease Extension (ABCDE) Project
title_sort study protocol audit and best practice for chronic disease extension abcde project
url http://www.biomedcentral.com/1472-6963/8/184
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